One of the most important learnings that the second Covid-19 wave has taught us is that India is an extremely resilient country. We are a bunch of people who have always had the fighting spirit and while the world started to write epitaphs on India, our quicker adaptation to the crisis made us by far the most successful country in combating Covid-19, fighting back hard! One of the major fears that the second wave brought with it is that it was reaching from the urban to the rural landscape. While metros like Mumbai and Delhi were infrastructurally better equipped, the infection, if let loose in the villages, would play havoc and that could mean a very high mortality rate. Uttar Pradesh, with its large girth and width and having most of its towns and cities falling in the Tier 1 & 2 bracket with a great number of villages, had been under the global scanner. Images of over-burdened crematoriums and dead bodies floating in the Ganga river made international headlines, yet the resilience of each and every frontline worker who worked on the ground was commendable. The situation was controlled sooner than later and today, the Uttar Pradesh Government’s Covid-19 combating model is getting global accolades. It has emerged as a “Yogya” or an ideal model, because of some very important health infrastructure related key decisions that the CM of that state took and was implemented by the entire administrative ecosystem of the state.
Covid-19 appropriate protocol management
Uttar Pradesh by far has been the leading state in testing. Covid-19 testing was done at the doorstep in remote villages. This was also commended by the WHO and Niti Aayog. That and social distancing norms along with Covid-19 appropriate protocols were strictly adhered to in the state. Festival congregations were cancelled and crowds were curbed. From a medical expert’s point of view, one of the most efficacious ways of combating the pandemic is maintaining and strictly adhering to the protocols. Strict actions were taken against people if found unmasked. Massive fogging & sanitization activities were carried out, which also helps in curbing the impact. Partial curfews have also effectively helped the state administration in a big way.
Breaking the Chain
Exceptional efforts were made in active surveillance, contact tracing and early detection to break the chain. The surveillance teams have reached out to the most mofussil parts of the states. Apparently among the 24 crore population of Uttar Pradesh, 18 crore have already been reached. These efforts lauded by the WHO were further amplified by the Australian MP, Craig Kelly’s reference to Yogi’s timely decision in the distribution of Ivermectin. The medicine was distributed as a preventive measure to people who come in contact with Covid patients and health workers. Today the cases are on a downswing and recoveries continue to outgrow the newly infected. Also, post Covid health complications are also being tracked and curbed effectively.
Mobilising and making state health infra robust
The state has been able to improve its health infra while in the middle of the Covid-19 war. From the first Corona patient having been admitted to the Safdarjung Hospital in Delhi to improving its healthcare infrastructure with over 1.75 lakh isolation beds, 1.25 lakh ICU/HDU beds and ventilators in all district hospitals with skilled and trained operating staff, the state has come a long way and in a break-neck speed. Doctors from reputed medical resources like SGPGI, KGMU, Atal Bihari Vajpayee, RML Institute were included in the advisory committee. This team is proving very beneficial for effective control and necessary strategy on curbing Covid. While most Covid-19 treatments were free in government hospitals, the government also mobilised the various health schemes to cater to the demand of health care funding in the state. Teleconsultation and an Integrated Command & Control Center (ICCC) came to the forefront and catered to the varied needs of those in preventive, treatment or crisis needs. Transparency in oxygen distribution is worth mentioning here. While the world saw the mismanagement and mayhem in oxygen supplies in the country, the government’s initiative in implementing an “Oxygen Monitoring System” is appreciated. The system was put in place to track the real-time demand of oxygen in hospitals and monitor the distribution, thereby curbing black marketeering and non-wastage of oxygen in the state.
Vaccination
Again a very commendable job in this area by the UP government. All vaccines are being given free of cost across all age groups. In order to cater to the demand of the state population, Uttar Pradesh was the first state to float global tenders for vaccine supply. Vaccine fests, vaccine promotion and educative drives to eradicate vaccine hesitancy are a critical part of the state’s vaccination drive today, with over 5 crore+ doses already administered. Despite not being resource rich the state has looked operational efficiency with local booths, vaccine reach-outs, etc…to effectively amplify the vaccination drive.
Preparation for the Third Wave
After being congratulated even by the Bombay High Court for Uttar Pradesh’s effective combating of the second wave, there’s no stopping to the preventive measures that are being taken by the state in standing guard against the probable third wave.
In view of the prediction made that this could severely affect children, the UP government has set up a 100 pediatric beds (PICUs) in all medical colleges and hospitals across the state. All state administrative bodies have been mobilised and are on high alert on this matter. As per a government published report, severely infected children will receive immediate admission in PICUs and they would be provided with treatment and oxygen facilities in these beds. Specialised training to deal with pediatric care is on in full swing so that there are adequately skilled people if the crisis hits.
In conclusion
While there are many political debates around Uttar Pradesh’s Covid-19 governance, my views are strictly as per my profession as a medical expert.
It would be only fair to comment importantly on the medical and health infrastructure related issues. And by far the state government of Uttar Pradesh and its model look absolutely as the “yogya” or an ideal model to work with in order to combat any large scale pandemic. The government, I am sure, has had a lot of learnings from this and they should come out periodically to share the same with other state bodies and even the medical fraternities and frontline workers. According to me, updation of knowledge and insights are key to combat all kinds of crises and large scale health crises such as this can surely contribute to a global readiness in the times to come.
Dr. Inder Maurya (MD), Emergency Medicine, ECFMG Cert. USA, Ex Senior Resident SGPGIMS Lucknow) and Founder & CEO, Foreign OPD®